Provider Demographics
NPI:1992567416
Name:ABUNDANT HEALTH CARE
Entity type:Organization
Organization Name:ABUNDANT HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SAWNTREACE
Authorized Official - Middle Name:TENE
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-206-7182
Mailing Address - Street 1:15072 ALYSSUM CT
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1602
Mailing Address - Country:US
Mailing Address - Phone:323-206-7182
Mailing Address - Fax:
Practice Address - Street 1:2450 COLORADO AVE STE 100E
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-5535
Practice Address - Country:US
Practice Address - Phone:844-226-7214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care